Agents for Diarrhea Flashcards
What is a Prostaglandin (-) that can be used to treat Diarrhea?
Bismuth
What is a Prostaglandin (-) that can be used to treat Diarrhea?
Bismuth
3 main classes of drugs to treat Diarrhea?
Opioid Agonists
Serotonin Antagonist
Cl- Channel Inhibitor
3 main classes of drugs to treat Diarrhea?
Opioid Agonists
Serotonin Antagonist
Cl- Channel Inhibitor
What are 3 Opioid Agonists to treat Diarrhea?
Loperamide
Diphenoxylate
Eluxadoline
What are 3 Opioid Agonists to treat Diarrhea?
Loperamide
Diphenoxylate
Eluxadoline
Does Loperamide exhibit analgesic/opiate-like effects?
No
- Nor physical dependence
MOA for Loperamide?
(Opioid Agonist)
= Acts on muscles of intestinal wall to slow/interfere with peristalsis
Possible adverse effects of Loperamide?
Cardiac toxicities leading to death
Anticholinergic effects
- Urinary retention, constipation, drowsy, blurred vision, etc.
Does Diphenoxylate exhibit analgesic/opiate-like effects?
Yes, at very high doses!
Diphenoxylate includes a small quantity of?
Atropine
Diphenoxylate includes a small quantity of?
Atropine
Why does Diphenoxylate have Atropine in it?
To discourage overdose/abuse
== Strong Anticholinergic effects!
MOA for Diphenoxylate?
(Opioid Agonist)
= Slows GI motility by acting on central/peripheral GI smooth muscle cells
What is the indication to use Eluxadoline?
IBS-D
irritable bowel syndrome - diarrhea subtype
Eluxadoline has 2 MOA. What are they?
- Agonist at mu and kappa receptors to slow peristalsis
2. Antagonist at delta receptors to decrease secretions
Adverse effects of Eluxadoline?
Constipation
Hepatic/Pancreatic enzymes
CNS related
Patients without a gallbladder on Eluxadoline are at an increased risk to develop?
Pancreatitis
Contraindications for patients to take Eluxadoline?
Alcoholism/Hepatic impairment
Pancreatitis disease or NO gallbladder
Which Opioid Agonist can treat IBS-D?
Eluxadoline
What is a Serotonin Receptor Antagonist (5HT3) used to treat diarrhea?
Alosetron
What is the indication to use Alosetron for Diarrhea?
Severe IBS-D that is NOT responsive to other treatments!!
What is the indication to use Alosetron for Diarrhea?
Severe IBS-D that is NOT response to other treatments
Adverse effect seen with Alosetron?
Ischemic Colitis
Which drug to treat Diarrhea can cause Ischemic Colitis?
Alosetron
Serotonin Receptor 3 Antagonist
You should not give your patients Alosetron if they have any?
GI or liver issues
What is a Cl- Channel Inhibitor to treat Diarrhea?
Crofelemer
What is a Cl- Channel Inhibitor to treat Diarrhea?
Crofelemer
What is a Cl- Channel Inhibitor to treat Diarrhea?
Crofelemer
What is the indication to give patients with Diarrhea Crofelemer?
Non-infectious diarrhea in HIV/AIDs patients on Anti-Retroviral Therapy!
Crofelemer is given to what patients?
HIV/AIDS on ART
HIV/AIDs patients with non-infectious diarrhea who are taking ART should be given what drug/class?
Crofelemer/Cl- Channel Inhibitor
What drug for Diarrhea was derived from sap of a croton lechleri tree?
Crofelemer
MOA for Crofelemer?
(-) Cl- secretion by blocking cAMP-stimluated CFTR and CaCC (calcium activated chloride channels)
Crofelemer (-) Cl- secretion from channels. Which channels?
CFTR and CaCC
- (calcium activated chloride channels)
